“There is no health without mental health. Mental health is essential for maintenance of the overall health and well being of individuals and the society at large. It affects the individual's ability to function, to be productive, to establish and maintain positive relationships and to experience a state of well being,'' says Dr Roy Abraham Kallivayalil, new national president of Indian Psychiatric Society (IPS).
In an exclusive interview, the IPS chief told The Hindu that about 14 per cent of the global burden of disease has been attributed to neuropsychiatry disorders, mostly due to the chronically disabling nature of depression and other common mental disorders, alcohol and drug abuse, and psychosis.
The number of psychiatrists in India is only 4,000 for 1.2 billion population, one psychiatrist for 300,000 people which is grossly inadequate. ``If we have to achieve a minimum ratio of atleast one psychiatrist for every 1,00,000 people, the number of psychiatrists should be trebled. Providing basic training in Psychiatry to medical graduates, and inclusion of Psychiatry a separate subject in the MBBS curriculum could fill up this huge vacuum,'' he said.
According to Dr Kallivayalil, training in Psychiatry to undergraduate medical students is very important as the knowledge of Psychiatry, mental health and behavioural sciences equips him to deal with various difficult and complex situations during medical practice. This will also help the students to develop proper communication skills and to empathise with the patients and their suffering.
Moreover, proper knowledge of Psychiatry would instill humanistic values in the students, further empowering them to establish and maintain a fruitful professional relationship with the patients, he said.
Depression on the rise
Though the prevalence rate of depression is higher than psychosis in modern times, the number of people treated are far lower due to the limited awareness about depression in the community. The situation is still worse in the rural areas, says he.
Dr Kallivayalil said the mental health infrastructure available in India was largely limited to large size custodial institutions, providing services to a limited group of the population and these institutions too were are a great source of stigma. The stigma in utilising psychiatric services, especially from Psychiatric hospitals, is another major issue concerning the healthcare, he said.
Cost-effective delivery
More than 70 per cent of India's population live in rural areas and a large majority of them avail treatment from primary health centres, especially for financial reasons. If the medical officers at these primary health centres have adequate knowledge in Psychiatry, it will be a great gain for mental health. He said delivering mental health care through primary care would be cost-effective and practical.
MCI decision sought
Dr Kallivayalil said IPS has already moved the Medical Council of India for making Psychiatry a compulsory subject for the MBBS course. There should be a separate theory paper, clinical examination and viva voce, as in the case of various other subjects, he said.
According to him, good training in Psychiatry during the under-graduate course will help the general practitioners to become well equipped, to consider the psychiatric and psychological factors from the outset, to reduce mortality and morbidity due to psychiatric illness, to provide cost-effective and cost-efficient treatment, and to avoid unnecessary investigations.
